Respiratory Diseases and the Fire Service - IAFF

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Respiratory Diseases and the Fire Service
Pneumonias ............................................................................................... 42
Pneumonia .......................................................................................... 43
Mortality and Severity Assessment .................................................... 44
Common Organisms Responsible For
Community-Acquired Pneumonias .................................................. 39
Hospital-Acquired Pneumonia .......................................................... 49
Other Lung Infections ............................................................................... 49
Lung Abscess ....................................................................................... 49
Pleural Effusions and Empyema ........................................................ 50
References.................................................................................................. 50
Chapter 2-3 • Tuberculosis: A Primer For First Responders ........................ 53
Introduction .............................................................................................. 53
Epidemiology of TB ................................................................................... 54
Pathogenesis, Transmission, Infection & Proliferation .......................... 56
Host Immune Response ..................................................................... 57
Progression From Infection to Active Disease .................................. 57
Clinical Aspects of TB Disease ........................................................... 58
Evaluation of Persons With Suspected Active TB Disease ............... 58
Diagnostic Microbiology .................................................................... 59
Treatment of Patients With Active TB Disease.................................. 59
Drug-Resistant TB ............................................................................... 60
Latent TB Infection ............................................................................. 60
Diagnostic Tests For TB Infection ............................................................ 61
Tuberculin Skin Test (TST) ................................................................. 61
Blood Tests (e.g. Quantiferon® - TB Gold) ......................................... 62
Populations Who Should Be Tested For LTBI ................................... 63
Interpretation of LTBIs: Causes of False Positive and
False Negative TST Reactions ............................................................. 66
BCG Vaccinated Individuals ............................................................... 66
Vaccination With Live Attenuated Vaccines ..................................... 66
Anergy ................................................................................................. 67
Two-Step Tuberculin Skin Testing ........................................................... 68
Clinical Evaluation For Latent TB Infection ............................................ 68
Medical History and Physical Examination ...................................... 68
Chest X-Ray.......................................................................................... 69
Sputum Examinations ........................................................................ 69
Considerations of Pregnant Women ................................................. 70
LTBI Treatment Regimens ........................................................................ 70
Isoniazid............................................................................................... 70
Rifampin .............................................................................................. 74
Rifampin & PZA Combination ........................................................... 74
Contacts to Multidrug Resistant TB (MDRTB) Cases ............................. 75
Treatment of Close Contacts With A Prior Positive
Test For TB Infection ........................................................................... 75
Monitoring Patients During Treatment ............................................. 75